Jessica Lüsebrink

Detection of Head-to-Tail DNA Sequences of Human Bocavirus in Clinical Samples

Parvoviruses are single stranded DNA viruses that replicate in a so called “rolling-hairpin” mechanism, a variant of the rolling circle replication known for bacteriophages like ϕX174. The replication intermediates of parvoviruses thus are concatemers of head-to-head or tail-to-tail structure. Surprisingly, in case of the novel human bocavirus, neither head-to-head nor tail-to-tail DNA sequences were detected in clinical isolates; in contrast head-to-tail DNA sequences were identified by PCR and sequencing. Thereby, the head-to-tail sequences were linked by a novel sequence of 54 bp of which 20 bp also occur as conserved structures of the palindromic ends of parvovirus MVC which in turn is a close relative to human bocavirus.

Pneumocystis jirovecii Can Be Productively Cultured in Differentiated CuFi-8 Airway Cells

ABSTRACT Although Pneumocystis jirovecii is a well-known and serious pathogen, all previous attempts to isolate, cultivate, and propagate this fungus have failed. This serious challenge in microbiology was addressed in the present study. We examined whether P. jirovecii could be cultured in a permanent three-dimensional air-liquid interface culture system formed by CuFi-8 cells, a differentiated pseudostratified airway epithelial cell line. Cultured pseudostratified cells were inoculated with bronchoalveolar fluid that had been confirmed to be positive for P. jirovecii using PCR. Five days later, the cells and basal medium were harvested and tested for P. jirovecii using quantitative PCR (qPCR), commercially available immunofluorescence detection assays, and Grocott staining of formalin-fixed, paraffin-embedded thin sections of infected-cell cultures. We successfully productively cultivated and propagated P. jirovecii from these P. jirovecii-positive bronchoalveolar lavage fluid (BALF) samples. Furthermore, we provide evidence that P. jirovecii induced cytopathic effects on lung epithelial cells and was even invasive in cell culture. To the best of our knowledge, the cell culture system developed herein represents the first methodology to enable molecular analyses of this pathogen’s life cycle and further in vitro studies of P. jirovecii, such as assessments of drug sensitivity and resistance as well as investigations of the pathogen’s stability against environmental factors and disinfectants. IMPORTANCE This is the first report of the successful productive cultivation and propagation of Pneumocystis jirovecii, a human-pathogenic fungus of major clinical significance. These findings are groundbreaking because they will influence the field of diagnostic microbiology, facilitate the testing of antibiotics against P. jirovecii, and enable stability studies of this pathogen when exposed to the environmental factors and chemicals that hospitals are required to use for disinfection. Because productively culturing P. jirovecii has been attempted unsuccessfully for several decades, this study represents a breakthrough in this field. This is the first report of the successful productive cultivation and propagation of Pneumocystis jirovecii, a human-pathogenic fungus of major clinical significance. These findings are groundbreaking because they will influence the field of diagnostic microbiology, facilitate the testing of antibiotics against P. jirovecii, and enable stability studies of this pathogen when exposed to the environmental factors and chemicals that hospitals are required to use for disinfection. Because productively culturing P. jirovecii has been attempted unsuccessfully for several decades, this study represents a breakthrough in this field.

Novel application for isothermal nucleic acid sequence-based amplification (NASBA).

Human bocavirus (HBoV), solely based on phylogenetic analyses, was classified as the second autonomous human parvovirus. Unfortunately, neither susceptible cell cultures nor animal models were described hitherto, thus complicating studies on viral genome structure and replication steps. A novel application of nucleic acid sequence-based amplification (NASBA) revealed that in all tested samples (100%) that became positive by NASBA the negative strand of the HBoV genome was packaged. Additionally, two of those samples also contained a detectable amount of positive strand (14.3%). The data confirm the assumed single-stranded negative-sense nature of HBoV-genomes that is independent of the viral subtype while showing that NASBA is useful not only for diagnosis.

High Seroprevalence of Neutralizing Capacity against Human Metapneumovirus in All Age Groups Studied in Bonn, Germany

ABSTRACT Human metapneumovirus (hMPV) infections occur frequently despite high rates of perpetual seroprevalence for all age groups. Analyses of ∼2,000 archived, randomly selected serum samples demonstrated that neutralizing capacities remain high, with a minor decrease for individuals over 69 years of age, leading to the hypothesis that reinfections occur because humoral immune responses play minor roles in the clearance of hMPV infections.

Does human bocavirus infection depend on helper viruses? A challenging case report

A case of severe diarrhoea associated with synergistic human bocavirus type 1 (HBoV) and human herpes virus type 6 (HHV6) is reported. The case supports the hypotheses that HBoV infection under clinical conditions may depend on helper viruses, or that HBoV replicates by a mechanism that is atypical for parvoviruses, or that HBoV infection can be specifically treated with cidofovir.

Comparison of two commercial PCR methods for methicillin-resistant Staphylococcus aureus (MRSA) screening in a tertiary care hospital.

Nose/throat-swabs from 1049 patients were screened for MRSA using CHROMagar MRSA, LightCycler Advanced MRSA, and Detect-Ready MRSA. Results were compared to the CHROMagar MRSA results, which was set as reference system. MRSA was detected in 3.05% of the patients with CHROMagar MRSA. LightCycler MRSA Advanced showed a higher clinical sensitivity (84.38%) than Detect-Ready MRSA (57.69%).The negative predictive values were high for both tests (>98%). The specificity and the positive predictive value were higher for the Detect-Ready MRSA test than for the LightCycler MRSA test (99.59% and 78.95% versus 98.52% and 64.29%). For routine screening LightCycler MRSA Advanced proved to be more efficient in our clinical setting as the clinical sensitivity was much higher than the sensitivity of Detect-Ready MRSA. CHROMagar MRSA detected more MRSA positive samples than both PCR methods, leading to the conclusion that the combination of PCR with cultural screening is still the most reliable way for the detection of MRSA. LightCycler MRSA Advanced was faster and needed less hands-on time. The advantage of Detect-Ready MRSA was the additional identification of methicillin-sensitive S.aureus (here in 34.63% of the samples), an information which can be possibly used for reducing the risk of postoperative infections in surgical patients in future.

Human HepG2 cells support respiratory syncytial virus and human metapneumovirus replication

Human metapneumovirus (hMPV) and human respiratory syncytial (RSV) virus cause mild to severe infections of the respiratory tract in all age groups. So far, several cell lines derived from respiratory tissues have been identified to support replication of both viruses. Unfortunately, titers attained during replication differ between the both viruses within one cell line despite equal infection conditions, on the one hand giving raise to the assumption that the individual susceptibility may vary in dependence of the virus, and, on the other hand, making it difficult to compare results between both viruses. Low titers may cause problems in experiments such as animal trials, in which high titers in low volumes are a prerequisite for successful experiments. The advantages are described of the use of a human cell line (normally used for hepatitis viruses research) susceptible for RSV and hMPV in which both viruses replicate to comparable and high titers. It is also shown that the cell line can also be used for applications such as cell viability tests. Cell viability tests can be used as reciprocal determination tests of viral titers and therefore offer the opportunity to replace classical virological tests such as TCID(50). The cell line can be also used for high throughput applications like drug screening, making it a useful tool for screening for antiviral compound active against RSV and hMPV.

Human Bocavirus - insights into a newly identified respiratory virus.

Human Bocavirus (HBoV) was discovered in 2005 using a molecular virus screening technique. It is often found in respiratory samples and is a likely cause for respiratory diseases in children. HBoV is distributed worldwide and has been found not only in respiratory samples, but also in feces, urine and serum. HBoV infections are mostly found in young children and coinfections with other respiratory viruses are often found, exacerbating the efforts to link HBoV to specific symptoms. The purpose of this review is to give an overview of recent HBoV research, highlighting some recent findings.

Epidemiology of EML4–ALK translocations in a small, German non-small-cell lung cancer patient cohort

BACKGROUND Fusions and translocations of the ALK gene are an important genetic marker in different types of cancer and are therapy relevant, especially in lung cancer, as they predict the patients response to crizotinib therapy. Thereby, EML4-ALK is assumed to be the most frequent fusion of ALK in lung cancer, although ALK is known to be able to fuse with approximately 20 different genes. PATIENTS & METHODS Formalin-fixed paraffin-embedded lung tissue from non-small-cell lung cancer patients previously tested positive for EML4-ALK were reanalyzed with three different FISH probe systems that are commercially available. RESULTS We describe a short series of patients with ALK translocations in which a surprisingly high percentage (66%) of non-EML4-ALK fusions were identified in non-small-cell lung cancer despite an estimated low percentage (˜20%) of such translocations. CONCLUSION Depending on the diagnostic method used, those patients could receive a false-negative diagnosis and would miss the chance to benefit from novel crizotinib therapy.

Low Titer Pneumocystis jirovecii Infections: More than Just Colonization?

Non-pneumonia Pneumocystis jirovecii colonization is thought to occur frequently in immunocompetent individuals. The aim was to analyze if P. jirovecii low-titer detections have more impact than just colonization. From our total cohort of patients for which P. jirovecii testing by qPCR was requested, we selected exclusively those that were fully immunocompetent. Patients were defined as fully immunocompetent if they did not receive immunosuppressive therapy, displayed regular antibody titers, and did not suffer from acquired, inherited or autoimmune diseases. Only those patients with complete medical records available were included. A retrospective analysis identified patients with P. jirovecii colonization and successful antibiotic therapy in response to laboratory pathogen detection. We identified 30 fully immunocompetent patients with P. jirovecii colonization suspected to suffer from infection with the pathogen, but with milder symptoms than pneumonia. All patients were successfully treated with cotrimoxazole against P. jirovecii and resolved from chronic cough and recurrent pulmonary infections. The fact that all patients displayed recovery from their clinical symptoms gives raise to the hypothesis that P. jirovecii infections may also occur in immunocompetent patients but with milder symptoms.